title: Tools for observational gait analysis in patients with stroke: a systematic review.
abstract: BACKGROUND
  Stroke severely affects walking ability, and assessment of gait kinematics is important in defining diagnosis, planning treatment, and evaluating interventions in stroke rehabilitation. Although observational gait analysis is the most common approach to evaluate gait kinematics, tools useful for this purpose have received little attention in the scientific literature and have not been thoroughly reviewed.
  
  
  OBJECTIVE
  The aims of this systematic review were to identify tools proposed to conduct observational gait analysis in adults with a stroke, to summarize evidence concerning their quality, and to assess their implementation in rehabilitation research and clinical practice.
  
  
  METHODS
  An extensive search was performed of original articles reporting on visual/observational tools developed to investigate gait kinematics in adults with a stroke. Two reviewers independently selected studies, extracted data, assessed quality of the included studies, and scored the metric properties and clinical utility of each tool. Rigor in reporting metric properties and dissemination of the tools also was evaluated.
  
  
  RESULTS
  Five tools were identified, not all of which had been tested adequately for their metric properties. Evaluation of content validity was partially satisfactory. Reliability was poorly investigated in all but one tool. Concurrent validity and sensitivity to change were shown for 3 and 2 tools, respectively. Overall, adequate levels of quality were rarely reached. The dissemination of the tools was poor.
  
  
  CONCLUSIONS
  Based on critical appraisal, the Gait Assessment and Intervention Tool shows a good level of quality, and its use in stroke rehabilitation is recommended. Rigorous studies are needed for the other tools in order to establish their usefulness.
authors.affiliation: F. Ferrarello, PT, Functional Rehabilitation Unit, Azienda USL 4 Prato, Piazza dell'Ospedale 5, 59100 Prato, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Ferrarello
authors.forename: Valeria Anna Maria
authors.initials: VA
authors.lastname: Bianchi
authors.forename: Marco
authors.initials: M
authors.lastname: Baccini
authors.forename: Gaia
authors.initials: G
authors.lastname: Rubbieri
authors.forename: Enrico
authors.initials: E
authors.lastname: Mossello
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Cavallini
authors.forename: Niccolò
authors.initials: N
authors.lastname: Marchionni
authors.forename: Mauro
authors.initials: M
authors.lastname: Di Bari
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D004185:Disability Evaluation; D005684:Gait / Q000502:physiology*; D006801:Humans; D015203:Reproducibility of Results; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation